臨牀消化器内科 Vol.26 No.9(4)


特集名 腹部超音波検査 up-to-date
題名 造影超音波検査
発刊年月 2011年 08月
著者 中田 典生 東京慈恵会医科大学放射線医学講座超音波診断センター
【 要旨 】 日本で,おもに使用されている超音波造影剤はソナゾイド®であり,経静脈投与によって,肝臓の腫瘤性病変の存在診断(病変の検出)と質的診断(悪性・良性の鑑別)に活用されている.ソナゾイドを用いた造影超音波検査は,肝臓に造影剤が最初に流入していくプロセスであるvascular phaseと肝臓のKupffer細胞に造影剤が取り込まれ撮像されるpost-vascular phaseに分けられる.典型的な肝血管腫はvascular phaseでfill-in patternが連続的に認められ,転移性肝癌ではpost-vascular phaseでは完全な陰影欠損,典型的なhypervascular HCCではvascular phaseでは腫瘍血管が描出され文字どおり血流豊富である.
Theme Abdominal Ultrasonography up-to-date
Title Contrast-enhanced Ultrasonography
Author Norio Nakata Department of Radiology, Jikei University, School of Medicine
[ Summary ] Sonazoid® is an ultrasound contrast agent, which has recently been used clinically in Japan. The role of Sonazoid, which is injected using intravenous bolus administration, is generally for detection and diagnosis of hepatic nodular lesions. The imaging phases of contrast US Sonazoid treatments are divided into a vascular phase and a postvascular phase (Kupffer phase). The vascular phase begins with the contrast agent flowing into the liver. The postvascular phase next produces images by employing an imaging contrast agent in the Kupffer cells of the liver. This occurs approximately ten minutes after injection. A typical hepatic hemangioma will exhibit a fill-in pattern in the vascular phase. Metastatic liver cancer will exhibit a filling defect in the post-vascular phase. A typical hypervascular hepatocellular carcinoma will exhibit tumor feeding vessels in the early vascular phase and filling defects in the postvascular phase.
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